Adolescent hirsutism

What is adolescent hirsutism?

This condition causes dark, coarse hair to grow – typically on the back, chest, abdomen, and face. Small amounts may be perfectly normal particularly if this runs in families.

What are the signs and symptoms of adolescent hirsutism?

Symptoms of hirsutism are mainly the appearance of excessive hair on the back, abdomen, chest and face. If there are extremely high levels of male hormones, additional symptoms of virilization (development of male characteristics) may appear.

These can include:

• Acne (severe)

• Deepening voice

• Enlarged clitoris (a small, sensitive area near the end of the vagina’s exterior)

• Increased muscle mass

• Receding hairlines or balding

• Reduced breast size

How is adolescent hirsutism diagnosed?

Hirsutism is diagnosed by an examination in the office. Sometimes laboratory values are obtained to look for abnormal hormone levels.

What are the causes of adolescent hirsutism?

Hirsutism can be caused by excess male hormones called androgens (hormones that regulate male characteristics) but primarily testosterone (responsible for male reproductive growth and muscle and bone mass). Hirsutism can also be inherited or familial (passed down through generations).

Other causes can include:

• Polycystic Ovary Syndrome (PCOS) - This hormonal disorder may lead to irregular menses, numerous “pea-sized” cysts on the ovaries and abnormal hair growth and/or excess acne.  The incidence is around 10% of women and girls.

• Tumors - An androgen (male hormone) secreting ovarian or adrenal gland tumor can lead to excess hair growth, and lead to virilization signs over a few months. These are very rare.

• Congenital adrenal hyperplasia (CAH) - The adrenal glands (found near the kidneys and produce several essential hormones) produce too many male hormones. This disease is inherited from both parents.  In adolescents with acne and hirsutism, this is very rare.

• Cushing’s syndrome - This syndrome can occur if the adrenal glands make too much cortisol or from extended use of prednisone (a corticosteroid used to treat a wide range of conditions). This is very rare, and the incidence is one a million individuals. 

• Medications like corticosteroid and phenytoin (Dilantin®) can alter the hormone and body chemistry, causing the hair growth.

What are the risk factors for adolescent hirsutism?

Ancestral region and inheritance – females of Mediterranean, Middle Eastern and South Asian ancestry have an increased risk of developing hirsutism. Some patients will remark ‘this runs in our family’.

How is adolescent hirsutism treated?

Hirsutism can be treated cosmetically by removing the excess hair such as laser hair removal. It can also be treated with medicines that can decrease the amount of  androgens in the patients body. Your provider will be able to provide all these options to you.